COVID and Ivermectin

 From comments in Nakedcapitalism.com (your mileage may vary):

IM DocNovember 20, 2021 at 11:20 am

There have been a few links on this site this week about ivermectin. Including a very well done discussion of the most important extant trials.

I would like to add a few things from my own experience about this drug. And where we are right now. In my area, we are again having what appears to be the early stages of yet another surge of COVID. This time, it is clearly involving many fully vaccinated and even boostered patients. And they are very ill. This is not a joke. In these patients, the vaccines have clearly failed in their mission. Seeing the tide coming in, even Dr. Fauci had to admit as such this week.

We supposedly have the new Pfizer drug (more on that in a second) and we now have the monoclonal antibody therapy. Unfortunately, the supply of the Pfizer drug is non-existent. And we have very limited supplies of the antibody drug. That drug is reserved for only patients that are high-risk and already very ill. Just so you can understand the magnitude of this issue – 68% of the patients who received the antibodies this week in my area were fully vaccinated, many boostered (I do not have that exact %). The other 32% were the unvaccinated. Again – the vaccinated patients are now getting sick enough to be in the “high-risk” group to get antibodies.

I do not believe anyone anticipated we would be in this situation with a fairly significant majority of the population vaccinated – but here we are. And now because of the severe staffing shortages and other issues, it is very important to do all we can to keep people out of the hospital safely.

As I have stated repeatedly, my experience in previous surges with this infection have demonstrated to my own eyes that Ivermectin is very capable of doing this. That is pretty much the only area in which I use it – patients who are positive whether ill or not get started on it immediately in addition to all of their primary contacts. Despite the months of propaganda from MSNBC and the CDC ( don’t take the horse dewormer y’all) , I have yet to have a single person have one issue with this medication. The same cannot be said for the vaccines. However, as is the case in every single viral infection in human medicine, once people are sick enough to be in the hospital, almost nothing works well. One of the agents we have been using, remdesevir, seems to do absolutely nothing beneficial that I can tell and often damages the patients. To be brief at that point of hospital admission – it is 100% support. It is critical to deal with patients early and strong in their illness.

I will say again – I was a very young doctor in the AIDS crisis working in an inner city hospital surrounded by dying AIDS patients at every turn. A very similar story was playing out at the time – and I guess WISDOM is the ability to learn from the mistakes of the past and never let them fool you again.

Pneumocystis carinii – the scourge of AIDS before we had effective anti-virals is the agent that killed the vast majority of my patients back then. Often abbreviated PCP. It causes a severe pneumonia. This bug is most definitely NOT a bacteria. In the 1980s it was thought to be a protozoa like ameba – however now we consider it more like a fungus ( I am not going into that here – suffice it to say it is NOT a bacteria). Interestingly, there were all kinds of agents in the 80s and early 90s for this agent that were actually doing far more damage than good to people – IV and inhaled pentamidine is the most common. And this drug was making mountains of cash for Big Pharma. From the front lines, various docs across the country started using a very old patent-expired ANTI-BACTERIAL called BACTRIM. 2 cents a pill. This had been used for decades at the time mainly in the treatment of urine infections. And docs all over America noticed how well it was working for PCP. All anecdotal – but vigorously shared. We had all had one too many cardiac arrests with the pentamidine. Some papers here and there appeared. All minimal studies because that is all you could really do as a lone wolf at the time. But overwhelming efficacy and minimal safety issues were noted. And then Dr. Fauci sent out the wolves. He and others were very busy promoting vaccine research, and antivirals that were very toxic, and keeping the pentamidine money train going. I sat through one conference after another deriding the use of BACTRIM as a pee pill by NIH experts sent to quell the rebellion. “How dare you use a bacterial agent against this protozoan fungus – the drug is not even in the right class”. The ridicule coming from these people at times was overwhelming. All kinds of papers and statistical manipulation was belched forth to try to subvert the evildoers. But the drug actually worked. And the doctors using it noted it. And persisted. And over the next few years, despite the NIH, Bactrim became the drug of choice for PCP – and still is to this day. I have not written a prescription for pentamidine in decades. Not even sure they still make it.

Therefore, was born an innate skepticism of Big Pharma and indeed of Dr. Fauci, in an entire generation of young doctors in this country.

One huge difference back then is we did not have the odious presence of the pathological liar Rachel Maddow and the morons at the NYT to poison the medical discourse. We did not have Big Pharma owning our entire media landscape with their ad dollars ( that did not start until the mid 1990s hat tip to the assholes Newt Gingrich and Bill Clinton). We did not have facebook and twitter and youtube to censor anything that was said about bactrim or pentamidine. We had ourselves, our colleagues, our wits, and our experience and our intellect. It was a much better world.

Unlike so many on both sides of the ivermectin issue which appear to be religious zealots, I came by my usage of this drug by doing a deep dive into the actual science. I was initially quite skeptical. But reading the basic science and some of these clinical trials made me feel very comfortable in trying it. The safety profile is so good that using it in this kind of crisis would be unethical. I am not alone in that assumption. Despite what the talking heads say on TV, every medical ethics conference I have been to about this topic, EVERY SINGLE ONE, to this day continue to state it is UNETHICAL not to use it.

Earlier this year, I attended a few conferences where the pharmacodynamics were discussed and the clinical trials discussed. It was there I learned from a PharmD that I know and trust that Big Pharma was starting their anti viral trials for COVID. And the candidates he had seen HAD EXACTLY THE SAME COURSE OF EFFECT ON COVID AS THE BASIC MEDICINE TRIALS WERE TELLING US ABOUT IVERMECTIN. Let me say that again – at least some of the Big Pharma agents being evaluated had the exact same effect on COVID as Ivermectin. I could not believe that at the time. Because this research is proprietary, it was unavailable to be looked at. But I did share this with the COVID brain trust back then. But here we are – on the verge of having this released – and indeed – THE PFIZER DRUG INHIBITS EXACTLY THE SAME PROTEASE INHIBITOR AS IVERMECTIN. The only difference is that ivermectin seems to be active against multiple other parts of COVID that this new Pfizer drug does not touch.

And where do the American people get to learn this? From Rachel Maddow? Sean Hannity? Chris Cuomo? The Paper of Record the NYT? The New Yorker? – Our elected officials? NO TO ALL – We get to learn this from a retired nurse in Great Britain and a comedian in his garage studio – https://www.youtube.com/watch?v=xROICA8Hr7I

Please note – the discussion that the nurse gives is the Cliffs note version of what I have been hearing for months. He makes it very easy to understand.

We are a corrupt and unserious nation. That includes my profession. They have managed to propagandize this issue for long enough now that the very word ivermectin is now radioactive. And just in time for the new 800 dollar a course Pfizer drug to hit the market – and there are others from other companies right behind them. Pigs feeding at the trough.

Where are the promised trials? I have been waiting all year. As a non-zealot, I would love to know one way or the other what the efficacy of ivermectin is……Will likely never know at this point. The cash register is just 2 steps away.

If you are high risk, get vaccinated. If you feel you are sick with COVID or are newly positive – get in touch with your doc. At my practice, we are now hitting it with all we have. I now have many patients demanding this approach. The Joe Rogan and Aaron Rodgers screeds from the MSM have done nothing but profoundly increase this desire. Antibodies if available. Ivermectin and fluvoxamine. And all the usual OTC. If you are vaccinated, do not assume there is a halo of protection – there most certainly is not. Continue to be diligent. Lose weight, sleep well, do all you can to decrease your stress level. Protect your vulnerable.

Reply ↓

1. urblintzNovember 20, 2021 at 9:08 pm

   Thank you IM Doc.

   Your patients are in the best of hands.

   Respect.

   Reply ↓
2. CarolinianNovember 20, 2021 at 10:12 pm

   Perhaps you can link to official sources that those of us could point our physician to should we unfortunately get Covid. I have no idea whether Ivermectin is allowed in my state but it would be helpful to at least have some ammunition to request a second opinion or access to someone who could write a prescription. I find your personal witness on this compelling but what are people to do when the medical establishment, or at least some of it, is trying to stymie a medication that is both legal and safe? Do patients have any right or say in the manner?

   Reply ↓
   1. Yves SmithNovember 20, 2021 at 11:15 pm

      The problem is physicians are receptive or they aren’t, so medical literature won’t persuade someone whose mind is made up. My MD was willing to prescribe me some initially but the anti-Ivermectin view is particularly strong in NYC so she’s backed off.

      Reply ↓
   2. OrcaNovember 21, 2021 at 12:32 pm

      You can find information about (IVM) treatment protocols and obtain prescriptions at the Front Line COVID-19 Critical Care Alliance website (look for Quick Links) –

      https://covid19criticalcare.com/

      Dr. Pierre Kory, former Chief of the Critical Care Service and Medical Director of the Trauma and Life
      Support Center at the University of Wisconsin and a Master Educator, tweeted that his colleagues have prescribed hundreds of IVM treatments to congressional staff.

      Reply ↓

Single Payer Healthcare comes to California

The following is from Assemblyman Kalra, who is submitting the bill. It's refreshing to hear from someone interested in solving public policy problems rather than climbing some slippery pole to more political power.


I’m Ash Kalra – I represent California’s 27th district in the State Assembly – and I introduced A.B. 1400, California’s single-payer health care bill (also known as CalCare) in February of this year.

First, I want to say thank you to everyone reading this email. You are a crucial piece of the movement for guaranteed health care in California, and I’ve watched all of the incredible organizing happening across the state in awe.

Second, as we prepare for CalCare’s highly anticipated return to the legislature in January, I wanted to share with you all some updates including notes from my recent CalCare Policy Tour. A more detailed recap of my trip can be found here, which I hope you’ll read and share.

In order to bolster and publicize our effort to create the best health care system possible for Californians, I wanted to learn from our neighbors in other countries and build alliances with other states and leaders in D.C.

So in late October, I decided to hit the road. I met with Canadian health administrators and elected officials, New York single-payer activists and the lead author of the NY state single-payer bill, members of Congress in D.C., and Biden's Health and Human Services (HHS) Department.

Here’s a quick snapshot:

In Canada, I met with health care providers in Deep River (a rural town in Ontario) to learn how their single-payer health system delivers care to its residents and how the system provides incentives for providers to serve rural areas of Canada.

I also visited Toronto and Quebec City where I met with academics and government officials at the provincial and federal level. It was interesting to learn how each province runs their own unique health care system and financing mechanism with financial support from the federal government.



Asm. Ash Kalra meets with Canadian health care leaders

In New York, I met with-long time New York Assemblymember Dick Gottfried, often referred to as the “Godfather” of New York’s single-payer bills, to share the history and challenges faced with passing a single-payer health care bill despite Democratic majorities.

I also met with organizers and activists from the Campaign for New York Health to hear how people are working to pass the New York Health Act (NY’s version of CalCare).

In D.C, I met with California Senator Alex Padilla, a longtime proponent of single-payer, who was eager to hear the steps being undertaken in California. I also connected with key Congressional supporters of the Medicare for All movement, including Congresswoman Katie Porter and Congressman Ro Khanna.

Then I met with representatives from the Department of Health and Human Services (HHS) to understand the steps for states considering federal waivers to capture federal funding for the purpose of a state-run single-payer health system. The main takeaway from the meeting was the reaffirmation that state legislative action is necessary first before a state can apply for federal waivers. That means it's crucial that we focus on passing AB 1400 through the state legislature.



Asm. Ash Kalra with Congresswoman Katie Porter

I know that the information gathered and relationships built during this tour help our movement as we continue to fight to pass single-payer health care in our state.

I’m feeling more energized and motivated than ever to bring single-payer health care to all Californians, and I’m so glad to be in this fight alongside all of you.

Please spread the word about this tour by sharing this blog post outlining the trip and what’s ahead.

Thank you for reading this far, and I look forward to working with you all soon as we ramp up for January.

With determination,

Assemblymember Ash Kalra
CA-27, San Jose

Inflation, the real story

from Naked Capitalism

“James K. Galbraith attributes the supply-chain problem in the US to a system that was built for efficiency, not resilience” [James K. Galbraith, Interest]. “None of these interpretations withstands scrutiny. The excess demand story fails on a glance. After all, there is no shortage of goods. Ships bearing the supply – 30 million tons of it – are sitting right now outside US ports, with more on the way. Nor have production prices risen by much. Most of the “inflation” so far has been in energy (driven partly by a rebound from the pandemic slump) and in used cars and trucks, previously produced goods that are in demand because of the semiconductor shortage affecting automakers. And no, that particular shortage is not the result of “excess demand,” either. During the pandemic, chipmakers predicted a bigger shift in the composition of demand – toward household gizmos and away from cars – than actually occurred. Now they have too much of one kind of chip and not enough of another. As for the “central planning” jibe, that is to be expected from certain circles. The implication is that all would be well if only the Biden administration had not been paying attention. Never mind that the extent of Biden’s intervention was merely to urge port managers to work “24/7” to get the boats unloaded – an idea that one assumes would have already crossed their minds. The point about “efficiency” gets closer to reality, except that the problem is not too little efficiency, but too much. To be precise, the extreme efficiency of today’s global supply chains is also their fatal flaw. Well-run ports are models of high throughput and low costs. They incorporate docks, railheads, truck bays, storage areas, and heavy-lifting equipment to suit the traffic they expect. Building capacity beyond a small margin of safety would be a waste. In normal times, any excess capacity sits idle, yielding no revenue while interest on the debt issued to build it still must be paid. Over time, efficient operators will minimize the excess and keep the docks and machinery they have humming away. The spectacular success of global supply chains – up until now – reflects the relentless operation of this principle…. A supply chain is an entire ecology, a biophysical entity. It requires all of its parts to function smoothly all of the time. Failures are not isolated to one segment, nor can they be fixed with a simple increase in prices or fees, or by some rapid change in techniques. Instead, they cascade through a system that was built in a specific way; a breakdown in one part can become a general one.”

 

In other words...cost-push, not demand-pull inflation is what we're witnessing. Also absent from conventional news coverage: how good it is to have the end of deflation.

Sacramento County Jail Gets Sacramento Bee Coverage...almost. An Open Letter to the Bee's Marcos Breton

(c) by Mark Dempsey

Dear Mr. Breton,

Thanks for covering the Sacramento County Jail November 10. Based on your coverage, and the overall philosophy of American incarceration, I'd suggested this motto for our justice system: "The beatings will continue until morale improves."

You mentioned that Sacramento lost a lawsuit because it was mistreating prisoners, but omitted a few details.For example, crime, arrests and convictions have all been declining, yet, as you mention in your article, the jail remains full, sometimes beyond its initial design capacity. The Decarcerate Sacramento organization estimates 50% - 70% of the prisoners in the jail are not convicted of anything, they just can't afford bail. That's right, it's illegal to be poor in Sacramento County.

You also didn't mention that the US has 5% of the world's population, but 25% of its prisoners. That's five times the world's per-capita average, and more prisoners in absolute numbers or per capita than any other nation, apartheid South Africa, Cuba and the USSR included. 

Canada is demographically identical, but per capita has only one seventh the incarcerated of the US. So is Canadian crime worse than US crime? Nope. About the same.

California's voters have recently approved some propositions to counteract this draconian regime, but the fight against that sensible move has included lies from our sheriff, and opposition from Sacramento's own DA. San Francisco elected a District Attorney (Gascon) to implement those propositions, and now that DA faces a well-funded recall, in spite of the continued decline in crime.

The problem is as much with what happens outside prison as goes on inside, too. The Federal Reserve reports 40% of US population can't handle a $400 emergency without selling something or borrowing. And the loans--particularly payday loans, and even credit card loans--are at exorbitant rates.

The desperation of a population attacked by creditors, riddled with COVID, scraping by from paycheck to paycheck, plays out in the confrontations with police. I have friends who are policemen and women, and I'd like their jobs to be safer, with fewer encounters with desperate people.

But the beatings will continue until morale improves.

It used to be common sense to believe public assistance was a cheap way to purchase social peace. Now, a large portion of the population believes welfare recipients are cheats and frauds.

The politically popular remedy for our social ills has been to cut welfare and food stamps. Not only that, crushing unions, the defenders of labor, has been an ongoing project of our public policy makers. 

Frauds and cheats abound among the wealthy. Because of fraudulent loans, an estimated ten million homeowners lost their homes in the subprime/derivatives meltdown. Who got the bailout? Wall Street, not Main Street. None of those Wall Street criminals went to jail, instead they paid dimes on the dollar of their loot in fines.

Also politically popular: more policing. Between 1981 and 2017 the US experienced a 42% population increase. During that same period, funding for the police had a 187.5% increase.The beatings will continue...

George Santayana was right when he said that "Americans are a primitive people, disguised by the latest inventions." The blood lust for more policing and punishment is ineffective, but the current system keeps people angry and defensive--sort of like your reporting about jail abuse that ended with anecdotes about how those released are terrorizing the neighborhood around the jail. 

But...the beatings must continue until morale improves.

An Economist explains how the job guarantee would work

 

Ladies and Gentlemen, the Democrats! (re: Virginia losses)

 

I love that Terry McAuliffe couldn’t attack Youngkin’s Carlyle group record because McAuliffe was an investor in a Carlyle fund.

Ladies and gentlemen, the Democrats!

— Matt Stoller (@matthewstoller) November 3, 2021

An echo of:

THIS IS WHY DEMS SUCK

⛔️NO filibuster reform
⛔️NO medicare for all
⛔️NO court expansion
⛔️NO abolishing ice
⛔️NO closing child cages
⛔️NO real climate action
⛔️NO paid family leave
⛔️NO end to droning civilians
⛔️NO minimum wage hike
⛔️NO student debt relief

— Peter Daou (@peterdaou) November 3, 2021

China vs. The U.S.' governance

From here:

Where liberal philosophers [like those who founded the U.S.] build systems to restrain the power of potentially vicious rulers with strict procedures, theorists of virtue politics [as in China] elevate the selection of rulers over the restriction of their power.

 

...

And from Confucius: "The inferior man thinks only of comfort. The superior man thinks only of virtue."